Individual
TASEAN D'ANDRE WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4215 SPRAGUE ST, OMAHA, NE 68111-2542
(531) 772-2379
Mailing address
4215 SPRAGUE ST, OMAHA, NE 68111-2542
(402) 415-5261
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
NE
Other
Enumeration date
01/29/2025
Last updated
01/29/2025
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